06-3808 (RPL)A
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
5
ou
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00003808
79400 STONEGATE
772 -020 -022 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
Tuvl-4 XPO"
Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT -
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License class: /C5533 License No.: 614611
Date:
%%� Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel or
that he or she is exempt therefrom and.the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for. a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: .
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
- the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The -
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offeied for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
• • • CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued ISec. 3097, Civ. C.1. '
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
CUMMINGS C T
79400 STONEGATE
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS & SPAS, I
83695 AVENUE 45
INDIO, CA 92201
(760)342-3612
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/25/06
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section. 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code,'for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier HRH INS Policy Number C20060333601
I certify that, in the performance of the work for which this permit is issued, I shall not employ any .
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
jjqq/�3700 of the Labor Code, I shall forthwith comply with those provisions.
'Date: �£�1 Applicant: C
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST. OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1: Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application;
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2.. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construc ion, and hereby authorize representatives
of this county to enter upon the above-mentioned property1f% ins y ion oses.
Date: Signature (Applicant or Agen,� .
Application Number . . . . . 06-00003808
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee 207.00 Plan Check
Fee
134.55
Issue Date Valuation
20000
Expiration Date 4/23/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
18.00 9.0000 THOU BLDG 2.,001-25,000
162.00
Permit MECH POOL
Additional desc.. .
-
Permit Fee . . . 26.00 Plan Check
Fee
6.50
Issue Date Valuation
. . .
. 0
Expiration Date 4/23/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
----------------------------------------------------------------------------
11.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee 45.00 Plan Check
Fee.,
11.25
Issue Date . . . . Valuation
0
- Expiration Date 4/23/07
Qty Unit Charge Per
Extension .
BASE FEE
15.00
1.00 30.0000.EA ELEC PRIVATE SWIMMING
POOL
30.00
Permit PLUMBING
Additional desc
Permit Fee27.00 Plan Check
Fee
6.75
Issue Date . . . Valuation
. . .
. 0
Expiration Date 4/23/07
Qty Unit Charge' Per
Extension
BASE FEE'
15.,00
1.00- 6:0000 EA -,PLB FIXTURE
.6.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
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Special Notes and Comments
SPA & WATERFEATURE ONLY PER APPROVED
LQPERMIT
Application Number
06-00003808
Special Notes and,Comments
PLANS..
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
305.00
.00
.00
305.00
Plan Check Total
159.05.
.00
.00
159.05
Grand Total
464.05
.00
.00
464.05
-LQPERDIIT -
W"' a City of La QuInta
Building at Safety Dhtslon
Permit # P.O. Box 1504, 76.495 Calle Tampico
U Quints, CA 92253 - (760) 777.7012
Building Permit Application and Tracking V g Sheet
>< Project Address: BU Owner's Name:
A. P. Number: Address:
Legal Description: City, ST, Zip:
Contractor � "�'7 , Mlephone:
Address: L f Project Description:
City, ST, Zip::QN tb � 2,2 .o (1
X
Telephone,,-':] Z �a r:`.4 - :st'
rX State Lic. # : Gry I City Lic. #-
Arch., Engr., Designer:
Address:
City. ST. Zip:
Telephone: •; Construction T
., ype: Occupancy:
State Lic. #:� ' '''`
> ' • Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: -1 C- � ' Sq •
. Ft.: #Stories # Units -
Telephone # of Contact Person: Sc: ; $' ' ' o stimated Value of Project: 0
_....._
T ..
AreU%,ANT: DO NOT WRITE BELOW THIS LINE
it Submittal
Req'd Ree'd TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed. ready for corrections
Plan Check Deposit
Truss Clles.
Called Contact Person
Plan Check Balance
Energy Calts.
Plans Oieked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review. ready for corrections/issue
Electrical
Subeoataetor list
Called Contact Person
Pluenbinb
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSEt.
14 Review. ready for eorreetions/issue
Developer Impact Fee
Planning Approval
Pub. Wks. AAppr
School Fees
Called Contact Person
Date or ptrmit issue
A.I.P.P.
Total Permit Fees
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